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Pediatric Dermatology May 2020Hypergammaglobulinemic purpura of Waldenström (HGPW), a rare cutaneous eruption characterized by the triad of recurrent episodes of lower extremity petechiae, symptoms...
BACKGROUND
Hypergammaglobulinemic purpura of Waldenström (HGPW), a rare cutaneous eruption characterized by the triad of recurrent episodes of lower extremity petechiae, symptoms of stinging and burning, and lower extremity edema, is poorly described in children. Some children have been reported to follow a benign course, while others are eventually diagnosed with fulminant rheumatologic disease.
OBJECTIVES
To determine the distinguishing features of HGPW including the spectrum of disease manifestations and clinical outcomes.
METHODS
This is a multicenter, retrospective case series of six children with HGPW combined with a literature review of 45 previously published pediatric cases.
RESULTS
Most children were eventually diagnosed with systemic disease (63%) or developed autoantibody accumulation suggestive of evolving disease (71%). The most common diagnoses were Sjogren's syndrome and systemic lupus erythematosus. The mean duration between onset of cutaneous eruption and diagnosis of systemic disease was 5.6 years, underscoring that HPGW patients often present with a rash that precedes the development of systemic symptoms.
CONCLUSIONS
Diagnosis of HGPW should prompt initial screening for rheumatologic disease with long-term rheumatology follow-up, as the majority of patients present with evolving manifestations of systemic disease.
Topics: Child; Humans; Lupus Erythematosus, Systemic; Purpura; Purpura, Hyperglobulinemic; Retrospective Studies; Sjogren's Syndrome
PubMed: 32104943
DOI: 10.1111/pde.14120 -
Pediatric Clinics of North America Nov 1972
Review
Topics: Adolescent; Antihypertensive Agents; Child; Child, Preschool; Complement System Proteins; Edema; Female; Humans; Immunosuppressive Agents; Infant; Intussusception; Kidney Diseases; Male; Prognosis; Purpura; Rheumatic Diseases; Skin Manifestations; Steroids; Syndrome; Urticaria
PubMed: 4562930
DOI: 10.1016/s0031-3955(16)32782-1 -
Journal of the American Academy of... Nov 1990Traumatic asphyxia is a distinctive clinical syndrome characterized by cervicofacial cyanosis and edema, multiple petechiae, and subconjunctival hemorrhage after a...
Traumatic asphyxia is a distinctive clinical syndrome characterized by cervicofacial cyanosis and edema, multiple petechiae, and subconjunctival hemorrhage after a severe crush injury of the thorax or of the upper part of the abdomen. A case of traumatic asphyxia is reported, and its clinical and pathophysiologic features are discussed.
Topics: Abdominal Injuries; Adult; Asphyxia; Conjunctival Diseases; Edema; Epilepsy; Face; Hemorrhage; Humans; Male; Purpura; Thoracic Injuries
PubMed: 2229538
DOI: 10.1016/0190-9622(90)70316-a -
British Medical Journal Jan 1971
Topics: Adult; Ecchymosis; Female; Humans; Psychophysiologic Disorders; Psychotherapy; Purpura
PubMed: 5539141
DOI: 10.1136/bmj.1.5739.30 -
Journal of the American Academy of... Nov 2005
Topics: Adolescent; Athletic Injuries; Child; Humans; Male; Purpura
PubMed: 16243154
DOI: 10.1016/j.jaad.2005.05.019 -
American Journal of Hematology Jul 1997
Topics: Female; Humans; Middle Aged; Psychophysiologic Disorders; Purpura
PubMed: 9256294
DOI: 10.1002/(sici)1096-8652(199707)55:3<146::aid-ajh5>3.0.co;2-s -
Emergency Medicine Journal : EMJ Aug 2010
Topics: Child; Cough; Evidence-Based Medicine; Exanthema; Female; Humans; Meningococcal Infections; Purpura; Vena Cava, Superior
PubMed: 20688941
DOI: 10.1136/emj.2010.097741 -
Pediatric Dermatology 2004We report two cases of bathtub suction-induced purpura. Two girls, ages 9 and 14 years, developed recurring purpura "spontaneously" in the same lower back location and...
We report two cases of bathtub suction-induced purpura. Two girls, ages 9 and 14 years, developed recurring purpura "spontaneously" in the same lower back location and in the same U-shaped distribution. The patients had similar histopathologic findings, with extravasated erythrocytes and a sparse superficial inflammatory infiltrate. After extensive evaluation, one patient eventually admitted to self-inducing her lesions by creating suction against a bathtub. The second patient denied self-inflicting her lesions; however, her purpura improved when she stopped taking baths.
Topics: Adolescent; Baths; Child; Factitious Disorders; Female; Humans; Purpura; Stress, Mechanical
PubMed: 15078356
DOI: 10.1111/j.0736-8046.2004.21212.x -
The American Journal of Forensic... Mar 1988Petechiae can be important corroborative evidence of asphyxia, but are also seen in persons who have died of other means. It is not uncommon to encounter them in cases...
Petechiae can be important corroborative evidence of asphyxia, but are also seen in persons who have died of other means. It is not uncommon to encounter them in cases in which cardiopulmonary resuscitation has reestablished blood flow and pressure in small vessels already damaged by hypoxia resulting in the formation of petechiae. This report documents some representative cases.
Topics: Adolescent; Adult; Autopsy; Cheek; Conjunctiva; Eyelids; Female; Humans; Male; Middle Aged; Purpura; Resuscitation
PubMed: 3354520
DOI: 10.1097/00000433-198803000-00009 -
Journal of Experimental Therapeutics &... Jul 2016Multiple myeloma (MM) is a dyscrasia caused by neoplastic proliferation of somatically mutated plasma cells. Myeloma cells divide and expand within the bone marrow... (Review)
Review
Multiple myeloma (MM) is a dyscrasia caused by neoplastic proliferation of somatically mutated plasma cells. Myeloma cells divide and expand within the bone marrow affecting multiple locations in the body where bone marrow is present. Oral manifestations, though common are usually not diagnosed. This report describes rare oral manifestations of multiple myeloma like oral petechiae and gingival swelling presented in a 40-year-old male patient. The diagnosis was established by blood examination & skeletal survey, while oral findings were later correlated with the diagnosis of MM. A brief review on MM is presented along with the demonstration of rare oral manifestations.
Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Biopsy; Bone Marrow Examination; Gingivitis; Humans; Male; Multiple Myeloma; Purpura; Treatment Outcome
PubMed: 28471126
DOI: No ID Found